Objective To explore the role of hypoxia-inducible factor 1α(HIF-1α)and carbonic anhydrase IX (CAIX)in oncogenesis and development of gestational trophoblastic disease (GTD).Methods The expressions of HIF-αand CAIX were determined immunohistochemically by specific antibodies on formalin-fixed paraffin sections of normal pregnancy villi (32 cases),hydatidiform moles (33 cases),and invasive hydatidiform moles (26 cases). Results The positive rate of HIF-1α in normal pregnancy villi (NP),hydatidiform moles (HM)and invasive hydatidiform moles (IM) was 28.1% (9/32 ), 45.5% (1 5/33 ) and 73.1% (1 9/26 ), respectively. It was significantly higher in IM than in HM and NP(P <0.05),and there was no statistical difference between the latter two groups (P >0.05).The positive rate of CAIX in NP,HM and IM was 31.2 (10/32),3.0(1/33)and 57.7%(1 5/26),respectively.It was significantly higher in IM than in HM and NP (P < 0.05 ),and CAIX was almost negatively expressed in HM group,which differed significantly from that in NP group (P <0.05 ).There was no correlation between HIF-1αand CAIX expressions in IM (P >0.05).Conclusion The expressions of HIF-1αand CAIX were both higher in gestational trophoblastic neoplasia than in normal pregnancy and hydatidiform moles, which indicates that HIF-1αand CAIX may play a role in oncogenesis and development of malignant transformation of trophoblastic cells.

Objective To investigate the clinical value of interventional ultrasound treatment for non-ruptured ectopic pregnancy. Methods Seventeen cases of ectopic pregnancy with masses 20~50 mm(mean,35 mm) in diameter and embryo sacs 15~42 mm(mean,26 mm) in diameter were included.Under the guidance of ultrasonography,needle puncture and aspiration of lesions of ectopic pregnancy was conducted through the posterior fornix.Then the methotrexate(MTX) 20~40 mg was injected into.Results All the 17 cases were punctured and MTX-injected on one session.The embryo sac disappeared within 4 weeks after the treatment in 16 cases,while there was no improvement in 1 case and a further surgery was given.Of the 16 successfully treated cases,salpingography showed the oviduct as "patent" in 14 cases and as "unobstructed" in 2.Conclusions Interventional ultrasound treatment of non-ruptured ectopic pregnancy has advantages of simplicity of performance,good safety and efficiency,minimal invasion,and few adverse effects.This procedure is worthy of being recommended.

Cytochrome P450 is one of the microsomal mixed function oxidase,and plays an important role in the metabolism of exogenous and endogenous material.Lots of domestic and overseas relative literatures were red,the article summarized the research progress of traditional Chinese medicine affecting the metabolism of CYP in recent years.Eight main drug-metabolizing enzymes were respectively introduced,including CYP1A1,CYP1A2,CYP2A6,CYP2C,CYP2D6,CYP2E1,CYP3A4 and CYP3A4.It is important to research CYP450 for drug screening,individual administration.

Objective:To determine the distribution of T-lymphocyte subpopulations in peripheral blood and its relationship with disease-free survival (DFS) of patients with different molecular subtypes of invasive breast cancer (IBC). Methods:Data and plasma samples of 372 female patients with IBC treated at Tianjin Medical University Cancer Hospital and Institute between January 2008 and August 2009 were obtained. CD4+/CD8+ratio and the amount of regulatory T cells (Treg cells) and natural killer cells (NK cells) were measured through flow cytometry. Results:A total of 133 (35.8%), 124 (33.3%), 48 (12.9%), and 67 cases (18.0%) presented luminal type A, luminal type B, HER-2 over-expression, and triple-negative type breast cancer (TNBC), respectively. In TNBC, a longer DFS was observed when the peripheral CD4+/CD8+ratio was high or when the level of Treg cells was low (CD4+/CD8+P<0.05 and Treg P<0.05). However, CD4+/CD8+and Treg are not independent prognostic factors for the DFS of TNBC cases. In other molecular subtypes of breast cancer, CD4+/CD8+ratio and the amount of Treg cells are not correlated with DFS (P>0.05). The level of NK cells is unrelated to the DFS of breast cancer with the four molecular subtypes (P>0.05). Conclusion:CD4+/CD8+ratio and the amount of Treg cells in peripheral blood may predict DFS of TNBC but are not considered as independent prognostic factors.

BACKGROUND: Sjogre's syndrome is a common disease of aged people,in which, dry mouth and throat have disturbed chawing, swallowing and speech and have seriously affected living quality of patients. OBJECTIVE: To probe into the improvement of oral function treated with Chinese medicine based on differentiation of symptoms. DESIGN: Retrospective analysis on cases was designed. SETTING: Department of Periodontal Disease, College of Stomatology,Fourth Military Medical University of Chinese PLA. PARTICIPANTS: Thirty-six cases of Sjogre's syndrome were selected from clinic of Department of Periodontal Disease of Stomatology College of Fourth Military Medical University of Chinese PLA from May 2000 to February 2004, with agreement and in the know of patients. Of those, 5cases were male, 31 cases were female, aged varied from 27 to 70 years,with duration of sickness in range from 0.5 to 10 years. METHODS: ① On basis of moistening, drying up heat, producing fluid and stopping thirst, the drugs for activating blood circulation, resolving stasis, clearing away heat and detoxification were supplemented. Formula:shashen (Radix Glehniae), maidong (Radix Ophiopogonis), shihu (Herba Dendrobii), yuzhu (Rhizoma Polygonati Odorati), huafen (Radix Trichosanthis), xuanshen (Radix Scrophulariae), shengdi (Radix Rehmanniae), chenpi (Pericarpium Cirri Reticulatae), danshen (Radix Salviae Miltiorrhizae), banzhilian (herba Scutellariae Barbatae), bahuasheshecao (Herba Hedyotis Dissusae), etc. ②Treatment of vitamins and transfer factor were associated.③ Artificial saliva in local was applied to prevent from secondary infection. ④ It was to test 99Tc m parotid function (After 99Tc m was injected intravenously on elbow, the parotid uptaking and concentrated 99Tc m curve were traced immediately. When radioactivity intensity was increased to maximum, the patients were required to chaw Vit. C tablet, 200 mg. In following, it was to trace the minimum of 99Tc m radioactivity on decreased curve. Normal imaging was illustrated clearly, the development after Vit. C stimulationwas declined swiftly. Time-radioactivity curve illustrated obvious uptaking and excreting segments. Positive results were unclear parotid development or the development after Vit. C stimulation was not declined obviously. Time-radioactivity curve was of horizontal type, low-horizontal type, parabola type or persistent rising type), erythrocyte sedimentation (ERS) (Normal value: 0-15 mm/h for male adult, 0-20 mm/h for female adult) and a part of immunology, such as rheumatoid factor, immunoglobulin (I gG normal value: 7.6-16.6 g/L), immune complex, etc. The effect was determined as increased saliva secretion and improved oral function. MAIN OUTCOME MEASURES: 99Tc m parotid function test, rheumatoid factor, ERS, IgG and immune complex were applied to determine the therapeutic effects of Chinese herbs. RESULTS:Thirty-six cases all entered result analysis. ① After treatment, the positive rate of rheumatoid factor was lower significantly compared with that before treatment [36.7％, 73.3％,(x2=6.796, P ＜ 0.01)]. The levels of ERS, IgG and immune complex were all decreased significantly compared with those before treatment [(35.50±5.65) mm/h,(13.47±1.58) g/L,(8.30±1.24) mg/L;(55.20±8.85)mm/h,(23.57±2.37) g/L,(14.96±2.21) mg/L; (t=3.549-4.962,P ＜ 0.01)]. The result of 99Tc m parotid function test and main determined indexes had been improved for all. ② After treatment, dry mouth, dry eye and general symptoms were all improved of various degrees and saliva secretion was increased. Total effective rate reached 80.7％. CONCLUSION: Treatment based on differentiation of symptoms is applied in Chinese medicine. On basis of moistening, drying up heat, producing fluid and stopping thirst, the drugs for activating blood circulation, resolving stasis, clearing away heat and detoxification are supplemented and effectively promote rehabilitation of oral function in Sjogre's syndrome,such as chawing, swallowing, speech, etc.

Objective To evaluate the effect of neuromuscular block on the airway sealing pressure of laryngeal mask airway (LMA) i-gel in patients undergoing general anesthesia.Methods Sixty patients scheduled for elective surgery under general anesthesia with LMA i-gel were randomly allocated to one of three groups (n =20 each):control group (group C),rocuronium 0.3 mg/kg group (group R1) and rocuronium 0.6 mg/kg group (group R2).Anesthesia was induced with target-controlled infusion of propofol and remifentanil.The target plasma concentration of propofol was 3.5 μg/ml,and the target effect-site concentration of remifentanil was 3.0 ng/ml.When the patients lost consciousness and after the target plasma and effect-site concentrations were balanced,LMA i-gel was inserted to perform mechanical ventilation.After insertion of LMA i-gel,rocuronium 0.3 and 0.6 mg/kg were injected in R1 and R2 groups,respectively.The airway sealing pressure of LMA i-gel was detected immediately after insertion of LMA i-gel and at 1 min after administration of rocuronium.Results There was no significant difference in the airway sealing pressure of LMA i-gel between groups and within groups(P ＞ 0.05).Conclusion Neuromuscular block has no significant effect on the airway sealing pressure of LMA i-gel in patients undergoing general anesthesia.

Objective:To study the clinical effect of corticosteroids (C S) with small dosage in the recurrence control of pemphigus. Methods: 25 cases of pemphigus were diagnosed by clinical and pathological examinati on.They were treated with CS at 60-80 mg/d in acute stage for symptom control.Th en,the dosage of CS was decreased by 5 mg in each following 2 weeks untill it re ached 2.5 mg/2 d. The treatment of 2.5 mg/2 d was continued for 1 year and was a ssisted with tripterygium polyglycoside, compound thalidomide, compound cyclopho sphamide (compounded with total saponins of ginseng), dapsone, and/or some kidne y-supplementing herbs. The patients were followed-up for 9~16 years.Re sults:No recurrence was observed in 16 cases(64%).Recurrence was found i n 9 cases(36%),among them 7(28%) were with light symptom and 2(8%) severe. Sever e side-effect was not found in all cases. Conclusion:The recurr ence of pemphigus may be controlled without severe side-effect by long-term us e of small dosage of CS assisted with proper immuno-inhibitors, immuno-regulat ors and/or some kidney-supplementing herbs.

Objective:To analyse the clinical characteristics and to study the effects of thalidomide combined with tripterygium glycosides in the treatment of Behcet disease.Methods:50 cases of Behcet disease were analysed retrospectively.26 of them were treated by thalidomide at 35 mg combined with tripterygium glycosides at 10 mg 3 times a day.24 cases were treated by levamisole at 50 mg 3 times a day with 3-day-treatment and 11-day-interval.All the patients were treated for 2 months.Results:Middle-aged male patients with chronic onset were common,oral ulcer was the first common symptom.The disease could damage all organs,however the oral mucosa,skin,oculus,genitalia and joint were commonly involved.Reaction of needle puncture was highly specific in the diagnosis.The effective ratio of treatment was observed in 92% of the patients treated by the combination of thalidomide with tripterygium glycosides and in 67% of those by levamisole.Conclusion:The clinical manifestations of Behcet disease are complex,its diagnosis mainly depends on symptoms and signs,reaction of needle puncture is helpful in diagnosis.Thalidomide combined with tripterygium glycosides is effective in the treatment of the disease.

OBJECTIVE:To evaluate the quality of TCM decoction pieces in our hospital preliminarily and explore the solu-tions for the problem of the quality of decoction pieces purchased by the hospital. METHODS:In Jun. 2012,a system was estab-lished by our hospital,where the quality inspector was designated to daily inspect new batches of TCM decoction pieces such as ap-pearance provided by suppliers. The batches of TCM decoction piece samples inspected and those of unqualified products from Jun. 2012 to May 2014 were calculated. The reasons of unqualified products were analyzed and corresponding solutions were made. RE-SULTS&CONCLUSIONS:Over two years,a total of 94 671 batches of TCM decoction piece samples were inspected by our hos-pital,among which 737 were unqualified products predominantly because of mildew,damage by worms,greasing,containing for-eign substances and others. The solutions to such problems included interviewing the suppliers,returning or discontinuing the use of crude drugs and special focus on particular seasons and on the demand for key varieties. The unqualified products rate in the quality inspection reduced from 0.56%in Jun. 2012 to 0.34%in May 2014. Therefore,setting the post of drug quality inspector in the hos-pital can ensure the quality of TCM decoction piece purchased,however,it need to improve the inspection and acceptance of quali-ty inspection by sampling,scoring and using the new technology.

Objective To investigate the routine ultrasound and contrast-enhanced ultrasound (CEUS) features of hepatic nodules in Budd-Chiari syndrome(BCS) after portacaval anastomosis.Methods Routine ultrasonography and CEUS were performed in 18 BCS patients with hepatic nodules after portacaval anastomosis.Results Appearance after portosystemic anastomosis,multiplicity,small size,presence of peripheral rim and hypervascularization were important ultrasound imaging features of hepatic regenerative nodules in patients with BCS.Nodules showedquick wash-in and slow wash-out pattern in CEUS.Sixteen cases showed center-to-periphery enhancement pattern in arterial phase and hyper-enhancement in portal phase and late phase.Two cases showed periphery-to-center enhancement pattern in arterial phase and periphery enhancement in portal phase and late phase.Conclusions Hepatic regenerative have different features on routine ultrasound and CEUS in patients with BCS after portacaval anastomosis,which are useful for differential diagnosis.